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Trainees' knowledge and application of guideline recommendations for colorectal cancer screening and surveillance
Rushad Patell1, Abhishek Karwa2, Rocio Lopez3
1Department of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Background:
Data shows that practicing physicians don't recommend colorectal (CRC) screening and surveillance as suggested by guidelines. We assessed knowledge of CRC guidelines in medical trainees.
Methods:
A survey assessing confidence and knowledge of published CRC guidelines was emailed to program directors (PDs) of Accreditation Council of Graduate Medical Education approved training programs in the United States. PDs were requested to forward it to trainees. We analyzed trainees' knowledge by answers to clinical vignettes and identification of factors required by guidelines for screening and post polypectomy colonoscopy interval. We compared confidence and knowledge by specialty.
Results:
586 trainees in internal medicine (159), family medicine and primary care (147), gastroenterology (114), general surgery (51), ob/gyn (78), urology (13), and colorectal surgery (13) responded. 97% reported following guidelines. 68% and 50% stated confidence recalling screening and surveillance guidelines, respectively. 16% and 8% correctly identified all factors and answered corresponding vignettes for screening and surveillance, respectively. Overall accuracy of screening ranged between 11-23% and was not different between specialties (p = 0.11) while significant differences were noted between specialties in surveillance knowledge (0-39%, p < 0.001).
Conclusions:
United States trainees' CRC screening and surveillance knowledge is poor. Measures are needed to enhance knowledge of CRC guidelines.